DOCUMENTS Initial Application Date: 7 Application# I 10O 0LiI
COI/
COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108E.Front Street,Lillington, NC 27546 Phone:(910)893-7525ext.2 Fax:(910)893-2793 www.harnett.orgipermits
"A RECORDED SURVEY MAP,RECORDED DEED(OR OFFER 10 PURCHASE)8 SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION**
LANDOWNER:Dakota Land Partners, LLCMailing Address 5511 Ramsey Street, Suite 100
City: Fayetteville State:N�Zip:25911 Contact Ng'. 910-401-5504 Email: Jeri.Elkins@mossycreekmgmtLart
APPLICANT':Dakota Land Partners, LLC Mailing Address:
City: State: Zip: Contact No: Email:
'please fill out�applivant information 11 different Ilan Iando ner
cLn `t_.f'. A 3 (L L
CONTACT NAME APPLYING IN OFFICE:Jeri Elkins Plane#910-401.55004
PROPERTY LOCATION:Subdivision: Mamie Bell Ridge V
Lot 7 -8,1 1 LotSS�'�" 11 Size.
6122
State Road#129!10 State Road Name: Old US 421 Map Book 8 Page:V �3 i 3cai
Parcel. 1301r13CkJ1 l X.79 i a PIN. 06.)70 (43 / 7 �Pb°
Zoning RA-30 Flood Zone: /v Watershed. K Deed Book 8 Page Sb 74/ 9 ?LOPawer Company':
'New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PROPOSED USE:
Monolithic
SFD:(Size 50 x #Bedrooms: ):
#Baths: 1 Basement(wiwo bath _Garage: Deck:_Crawl Space:_Slab: 1 Slab
(Is the bonus room finished?( )yes ( )no wl a closet?U yes ( )no(if yes add in with#bedrooms)
❑ Mod: (Size x )#Bedrooms_#Baths_Basement(w/wo bath)_Garage:_Site Built Deck: On Frame ON Frame_
(Is the second floor finished?U yes (J no Any other site built adddions?( )yes (_j no
❑ Manufactured Home:_SW_DW TW(Size x )4 Bedrooms: Garage: (site built? )Deck: (site built? )
❑ Duplex:(Size x )No.Buildings: No. Bedrooms Per Unit:
❑ Home Occupation:#Rooms: Use Hours of Operation: *Employees:
❑ Addition/Accessory/Other:(Size_x )Use'. Closets in addition?( 1 yes (_)no
Water Supply / County Existing Well _New Well(#of dwellings using well )'Must have operable water before final
Sewage Supply: / New Septic Tank(Complete Checklist) _Existing Septic Tank(Complete Checklist) _County Sewer
Does owner of this tract of land,own land that contains a manufactured home within five hundred feet(500)of tract listed above?( )yes (J no
Does the property contain any easements whether underground or overhead( )yes (✓)no
Structures(existing • • oposed): -'nolo family dwellings: j Manufactured Homes: Other(specify).
Required Residential Property Line Setbacks:1 ^� Comments:
Front Minimum e� 2�
Actual '�V%
Rear I,L,I'''
rl
Closest Side 1° r2
Sidestreeticorner lot
Nearest Building
on same lot
Finer or_'
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: al N , IC/ / Cryie
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U+ /.tmei< LI , (Ad ei sulci ( )3 Ll /,i,
lei- (ln IYlamle . -Fes ti son DI e -F-I- onfrD
(11Qiwe SII a 'CI(L.-de-
llpermits are granted I agree to conform to all ordinances and laws of the State of North Carolina regulating such work and the specifications of plans submitted.
I hereby state that foregoing statements are accurate and co est of my knowledge. Permit subject to revocation if false information is provided.
.15n/I 7
Signature of Owner or ne ' Agent Date
"It is the owner/applicants responsibility to provide the county with any applicable information about the subject property,including but not limited
to:boundary information,house location,underground or overhead easements,etc.The county or its employees are not responsible for any
incorrect or missing information that is contained within these applications.***
**This application expires S months from the initial date if permits have not been issued^
m..; rade 2.n-
1 NOTE
ALL DIMENSIONS, LOCATIONS AND FEATURES SHOWN ON
THIS PLOT PLAN ARE APPROXIMATE AND ARE ONLY AN
re
/
ARPSTS RENDITION. EXACT LOCATION OF ALL FEATURES
p J ARE SUBJECT TO CHANGE AND MAY NOT BE INSTALLED
^y. EXACTLY AS SHOWN N PLANS AND/OR IN MODELS.
JIDEWALKS AND
Tp -j- SQ / EXTERIOR NFEATURES T OF EARE SUBJECT TO MODIFICATION AS
LI rySy DEEMED NECESSARY BY MELD PERSONNEL.
O_2 /
Z 2 /
OLD US HWY 321 / CUSTOMER DATE
S.R. 1291 /
/ CUSTOMER DATE
�F�F� •
Pp
grE ?re-CO
40 10' SETBACK
/ e `SO• WADE JURNEY REPRESENTATIVE DATE
N 3s.
VICINTIY MAP / It
`S9.
Not To Scale /
SFTIHACKS
/ N
/ N FRONT - 35'
SIDE - 10'
/ 2‘ 2S. �sE REAR — 25'
i/ `S.9T QS.
CORNER SIDE - 20'
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ROBERT W. WINSTON. JR. & / O
JOEL L. WINSTON / y^^
DB 2785 PG 727 / "e
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197,041 S.F.
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�' i 4.52 AC WBEDROOMS___ ±. .-_
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/ Z T'4ID TNIS PROPERFV Io.M EET TO
1 O ANY AND ALL APP CABLE DEED
RESTRICTIONS. EASEMENTS,
/ N RIGHT-OF-WAY, UTILITIES AND
11 O RESTRICTIVE COVENANTS WHICH MAY
1 6 BE OF RECORD OR IMPLIED.
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�1 1 a m APPROVAL FOR STAKING:
12 THIS PLOT PLAN IS CORRECT AND AIS HEREBS Y PROVED APBY
FOR STAKING ON THE
/ C;` 1g18800-CAR DATE SHOWN BELOW.
1,^ P, 7/25/722 016 7 25
/ N 1 REV. WADE JURNEY HOMES REPRESENTATIVE DATE
N • 1 W
CcR i& 1C 14 e 114.6' o IMPERVIOUS SURFACE AREA
PI 1' 6P y � o -4 DESCRIPTION AREA
16 0' 5 D r -1 HOUSE w/ PORCH 2,078 S.F.
r'' 1a PATIO/HVAC 18 S.F.
/ OA 81.1' m DRIVEWAY & WALKS 721 S.F.
I Z L__--__ __ > TOTAL (PROPOSED)= 2,817 S.F.
\ Z i----------S 84'53'09" E 169.17 10' SETBACK
� LOT AREA = 197,041 S.F.
W 0 % IMPERVIOUS AREA =1.4%
JOZ >j
F- �R.BOA I THIS DRAWING DOES NOT
yIOn REFLECT AS-BUILT INFORMATION
CURVE RADIUS ARC LENGTH CH LENGTH CH BEARING PRELIMINARY PLAT
Cl 50.00' 98.81' 83.50' N 52'51'29" W NOT FOR RECORM'ION, CONVEYANCES OR SHE&
100 we HOUSE LOCATION PLOT PLAN
RRA RRA FOR
SCALE: 1" - 100' TILDEN HOWINGTON DRIVE
IDE' 1 IA1 ,- T LOT 70A, MAMIE BELL RIDGE, PHASE FIVE
Upper Little River Township, Harnett County, North Carolina
LAND SERVICES, P i r• PROPERTY OF: WADE JURNEY HOMES
1500 Piney Plains Road, Suite 102 MAP BOOK 2013 PAGE 321 DEED REFERENCE
Cary, North Carolina 27518
Phone (919) 977-1554
Firm License N P-0573 DRAWN BY: E.G. IDATE: APRIL 19, 2017
NAME:j n LL1c j fel'-t+nc s L-1-6 APPLICATION#:
"This application to be filled out when applying for a septic system inspection.*
County Health Department Application for Improvement Permit and/or Authorization to Construct
IF THE INFORMATION IN THIS APPLICATION IS FALSIFIED.CHANGED.OR THE SITE IS ALTERED.THEN THE IMPROVEMENT
PERMIT OR AUTHORIZATION TO CONSTRUCT SHALL BECOME INVALID. The permit is valid for either 60 months or without expiration
depending upon documentar n submitted. (Complete site plan=60 months;Complete plat=without expiration)
910-893-7525 option I CONFIRMATION #
Environmental Health New Septic SvstemCode 800
• All property irons must be made visible. Place `pink property flags" on each corner iron of lot. All property
lines must be clearly flagged approximately every 50 feel between corners.
• Place ''orange house corner flags"at each corner of the proposed structure. Also flag driveways, garages, decks,
out buildings, swimming pools, etc. Place flags per site plan developed at/for Central Permitting.
• Place orange Environmental Health card in location that is easily viewed from road to assist in locating property.
• If properly is thickly wooded, Environmental Health requires that you clean out the undergrowth to allow the soil
evaluation to be performed. Inspectors should be able to walk freely around site. Do not grade property.
• All lots to be addressed within 10 business days after confirmation.$25.00 return trip fee may be incurred
for failure to uncover outlet lid,mark house corners and property lines, etc. once lot confirmed ready.
• After preparing proposed site call the voice permitting system at 910-893-7525 option 1 to schedule and use code
800 (after selecting notification permit if multiple permits exist) for Environmental Health inspection. Please note
confirmation number given at end of recording for proof of request.
• Use Click2Gov or IVR to verify results. Once approved, proceed to Central Permitting for permits.
7 Environmental Health Existing Tank Inspections Code 800
• Follow above instructions for placing flags and card on property.
• Prepare for inspection by removing soil over outlet end of tank as diagram indicates, and lift lid straight up (if
possible) and then put lid back in place. (Unless inspection is for a septic tank in a mobile home park)
• DO NOT LEAVE LIDS OFF OF SEPTIC TANK
• After uncovering outlet end call the voice permitting system at 910-893-7525 option 1 & select notification permit
if multiple permits, then use code 800 for Environmental Health inspection. Please note confirmation number
given at end of recording for proof of request.
• Use Click2Gov or IVR to hear results. Once approved, proceed to Central Permitting for remaining permits.
SEPTIC
If applying for authorization to construct please indicate desired system type(s): can he ranked in order of preference.must choose one.
(—) Accepted { ) Innovative {4 Conventional 1_I Any
1_1 Alternative II Other
The applicant shall notify the local health department upon submittal of this application if any of the following apply to the property in
question. If the answer is"ye ',applicant MUST ATTACH SUPPORTING DOCUMENTATION:
(_)Y11.5 1_11 NO Docs the site contain any Jurisdictional Wetlands?
1—I YES {K I NO Do you plan to have an trrigidiop system now or in the future?
{_}YES { 4NO Dues or will the building contain any drains?Please explain.
{ }YES lit) NO Are there any existing wells.springs, waterlines or Wastewater Systems on this property?
IIYES j .I NO Is any wastewater going to he generated on the site other than domestic sewage?
1 IYES {X) NO Is the site subject to approval by any other Public Agency?
1_1 YES {hi) NO Are there any Easements or Right of Ways on this property?
1_I YES I NO Does the site contain any existing water,cable,phone or underground electric lines?
If yes please call No Cuts at ROO-632-4949 to locate the lines. This is a free service.
I Have Read This Application And Certify That The Information Provided Herein Is Tnte,Complete And Correct. Authorized County And
Slate Officials Are Granted Right Of Entry To Conduct Necessary bupecfions To Determine Compliance With Applicable Laws And Rule.s.
I Understand That I Am Solely Responsible For The Proper Identification And Labeling Of All Property Lines And Corners And\laking
The Site Accessible So That A Complete Site Evaluation Can Re Perfortped. - //r//
PROPERTY OWNERS OR OWNERS LEGAL REPRESENTAT F ' GNATURE(REQUIRED) t ,DATF
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North Caroline 3200 N0 300.0 0/92013
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�► 101111 I IR
09109111 Application
# p
Harnett County Central Permitting (4
I 'i1 a8
Each section below to be filled out FC Box 65 Liuington NC 27548
by whomever performing work 910 893 7525 Fax 910 893 2793 www barnaorg/pemmla
Must be owner or licensed
contractor Address company Aoohcation for Residential Building andTrades Pe
name 8 phone must matchPerna;
Owners Name L*J1Lt Ju rhL4. ( I4wtth LLC Date Lei 13tn
Site Address 1130 T1l6Pn t1t./)ntr 4nit 09 � Phone QIG-445-Sy.GL/
Directions to job site from Lillington 4A.9..0 . A1C, 141.04 Z 105 1-g.t_ La-4 ()Ma
5.Ma4n6+. 41: in4-urnPnnlo ,C. n4
Subdivision ( P1 OXV1lL SL.Il e ta5t Lot 7 $ A
Descnption of Proposed Work SCE. #of Bedrooms
Heated SF 1200 Unheated SF 40t. Finished Bonus Room? Crawl Space _Slab 1(
General Contractor Information
k1.111/ c_ 336Z z- &a((
Building Cohtractor s Company Name Telephone ,,,��
... , a . . _4 . ' .fc. l �•_. O TrztjD,'1z.P(t4 chinepi...f si.�outh.
Address Z741b Email Address CO Ili
y4Z4Z
License#
leectneal Contractor Information
Description of Work ttt1 PL(A.A 't"(g61/4j 1 Service Size _Amps T-Pole lyes_No
aier,i.cyl LLtg-nCta1 care-5k-1.4ogn
Electrical Contractors Company Name Telephone
111'1 jL.DO. 4Lzeo S7i1 nglen ,ti2.15
Address Email Address
I O51 Le
License
Jdechapical/HVAC Contractor Information
Description of Work. 1.11/ G Air
Cprvt r+Air 33U-14N 4730
Mechanical Contractors Company Name Telephone
90. Eo . 571 GILnmant621oiZ.
Address Email Address
4-1712
License #
plumbing Contractor Information,
Description of Work PIQM(O t nV.‘ 54144-aA I #Baths
daily PlumbingTMC 3/G • 4- 16 -A
Plumbing Contractors Company-Name Telephone
L-16 3g Lt w.Gt 0.1) .
Address Email Address
LUfso4
License #
Insulation Contractor Information
‘3.1:1\6-13-0. �rtcW a+;airN
Insulation Contractors Company Name &Address Telephone
*NOTE General Contractor must fill out and sign the second page of this application
I hereby certify that I have the authority to make necessary application that the application is correct
and that-the construction will conform to the regulations in the Building Electrical Plumbing and
Mechanical codes and the Hamett County Zoning Ordinance I state the information on the above
contractors is correct as known to me and that by signlne below I have obtained all subcontractors
permission to obtain these permits and if gay changes occur including listed contractors site plan
number of bedrooms building and trade plans Environmental Health permit changes or proposed use
changes I certify it is my responsibility to notify the Hamett County Central Permitting Department of
any and all changes
EXPIRED PERMIT FEES-0 Months to 2 years permit re-issue fee is$150 00 After 2 years re-issue fee
is as per current fee schedple
ea..b.A.C, u113t1]
Signature of Owner/Contractor r(s)of Corporation Date
Affidavit for Worker's Compensation N C G S 87-14
The undersigned applicant being the /
General Contractor _Owner V Officer/Agent of the Contractor or Owner
Do hereby confirm under penalties of perjury that the person(s) firm(s)or corporation(s)performing the work
set forth in the permit
Has three(3) or more employees and has obtained workers compensation insurance to cover them
Has one(1)or more subcontractors(s)and has obtained workers compensation insurance to cover
them
/Has one(1)or more subcontractors(s)who has their own policy of workers compensation insurance
covering themselves
Has no more than two(2)employees and no subcontractors
While working on the project for which this permit is sought it is understood that the Central Permitting
Department issuing the permit may require certificates of coverage of workers compensation insurance pnor
to issuance of the permit and at any time during the permitted work from any person firm or corporation
carrying out the work
Company or Name/ !Al 114-t�.
•
Sign w/Tide,rald. 1 rnni4-O orr,l rn,l.nDate (41131.I^1
DO NOT REMOVE!
Details: Appointment of Lien Agent
Entry At: 668428 Filed on: 3017
Initially filieded by:by: wjh2013
Designated Lien Agent Project Property
Print & Post
invecton Title I nsuranse Company MOR IRA
THD Tilden Howinymn Dr. O;t O
nano..awu[prism scal Lillingron.NC 27546
S y ' �
Aaare :ry w. Ilangea Si Suite w9 Raleigh, Harnett County ,Negress.
V ^rnl O
rnane:ssnexivrl
Property Type Contractors:
Dm:4115xti51 l IPlease post this notice on the lob Sge
Email:auownaIncase Nem _ 1-2 Family Dwelling Suppliers and Subcontractors:
Scan this Image with your smart phone to
Lew this filing You can then filen Nonce
Owner Information
to Lien Ahem for this proj.<t.
WIH,I.IC
3300 Battleground Ave Suite 230
Greensboro. NC 39410
United States
Email uW.izgwadojumeybomes Qom
Phone 914-995-5654
View Comments 101
lechnkal Support llodine:IXXX1 h90-13X-4